An electronic health record-based intervention did not significantly decrease 30-day rehospitalization compared with control (18.8% vs 19.9%; HR 0.94, 95% CI 0.81-1.1).
RCT (n=3,661)
Does an electronic health record-based transitional care intervention improve follow-up office visits and reduce rehospitalization in older adults discharged from the hospital?
An EHR-based transitional care intervention with automated alerts did not significantly improve the timeliness of primary care follow-up or reduce 30-day rehospitalization in older adults.
Hazard Ratio: 0.94 (95% CI 0.81–1.1)
Absolute Event Rate: 18.8% vs 19.9%
OBJECTIVES: To assess the effect of an electronic health record-based transitional care intervention involving automated alerts to primary care providers and staff when older adults were discharged from the hospital. DESIGN: Randomized controlled trial. SETTING: Large multispecialty group practice. PARTICIPANTS: Individuals aged 65 and older discharged from hospital to home. INTERVENTION: In addition to notifying primary care providers about the individual's recent discharge, the system provided information about new drugs added during the inpatient stay, warnings about drug-drug interactions, recommendations for dose changes and laboratory monitoring of high-risk medications, and alerts to the primary care provider's support staff to schedule a posthospitalization office visit. MEASUREMENTS: An outpatient office visit with a primary care provider after discharge and rehospitalization within 30 days after discharge. RESULTS: Of the 1,870 discharges in the intervention group, 27.7% had an office visit with a primary care provider within 7 days of discharge. Of the 1,791 discharges in the control group, 28.3% had an office visit with a primary care provider within 7 days of discharge. In the intervention group, 18.8% experienced a rehospitalization within the 30-day period after discharge, compared with 19.9% in the control group. The hazard ratio for an office visit with a primary care physician did not significantly differ between the intervention and control groups. The hazard ratio for rehospitalization in the 30-day period after hospital discharge in the intervention versus the control group was 0.94 (95% confidence interval = 0.81-1.1). CONCLUSION: This electronic health record-based intervention did not have a significant effect on the timeliness of office visits to primary care providers after hospitalization or risk of rehospitalization.
Gurwitz et al. (2014) conducted an RCT in Hospital discharge (n=3,661). Electronic health record-based transitional care intervention vs. Control was evaluated on Rehospitalization within 30 days after discharge (HR 0.94, 95% CI 0.81-1.1). An electronic health record-based intervention did not significantly decrease 30-day rehospitalization compared with control (18.8% vs 19.9%; HR 0.94, 95% CI 0.81-1.1).